Age, Education Level Shown to Influence Genomic Profiling Adherence in Patients With Metastatic Genitourinary Cancers

Reasons for pursuing genomic profiling among patients with metastatic genitourinary cancers included guiding treatment and improving therapeutic response, in which age and education level were found to significantly influence shared decision making. Abstract findings were reported at the 2022 American Society of Clinical Oncology (ASCO) Genitourinary Cancers (GU) Symposium.

Although use of genomic profiling has been associated with cost savings and improved outcomes for diseases such as advanced non–small cell lung cancer, researchers highlight that limited patient knowledge regarding these tests could create barriers to shared decision-making.

Findings of a previous study indicated that concerns about negative emotions, information relevancy, and government entities having access to information were some of the major reasons patients refused to receive medically actionable secondary genetic findings (SFs).

Moreover, Black patients were shown to refuse SFs significantly more than White and Asian American participants (47.7% vs 31.7%), primarily due to distrust with the National Institutes of Health regarding their genetic information.

“Effective provider communication can address such barriers, but little is understood regarding patients’ perceptions of genomic profiling,” noted the abstract authors.

In seeking to better understand characteristics that influence shared decision making to pursue genomic profiling, researchers conducted a cross-sectional study of patients with advanced genitourinary cancers, including bladder, renal, and prostate cancers, who were referred for the tests. Participants responded to a survey designed to assess reasons for pursuing genomic profiling.

“Clinicopathologic characteristics were collected via chart review. Kolmogorov-Smirnov tests were used to assess associations between reasons to pursue genomic profiling and patient characteristics,” the investigators wrote.

A total of 126 patients were included in the analysis (average age, 67 years; marital status, 78% married; education, 76% some college; 75% male), with diagnoses of renal cell carcinoma (67%), urothelial (19%), and prostate cancer (14%) identified.

Among the study cohort, the most common reasons to pursue genomic profiling by patient response were reported as follows:

• To guide treatment (73%)
• To improve treatment response (32%)
• To follow physician’s indication (27%)
• To predict treatment response (23%)
• To learn about their disease (19%)
• To contribute to science (12%)

Regarding patient characteristics associated with pursuing genomic profiling, older age was significantly associated with 3 reasons, including to guide treatment (P = .001), to follow physician’s indication (P = .03), and to contribute to science (P = .001). No association was found among younger patients.

Moreover, a higher level of education was associated with the desire to guide treatment (P = .001), whereas a lower level of education was associated with the decision to follow physician’s indication (P = .002).

“This study highlights important associations between reasons to pursue genomic profiling and age and level of education,” concluded the authors. “Differing strategies for information delivery could be considered when communicating genomic profiling benefits to older patients and to patients with lower levels of education.”

Reference

Malhotra J, Philip EJ, Govindarajan A, et al. Characteristics associated with common reasons to pursue genomic profiling among patients with metastatic genitourinary cancers. Presented at: ASCO GU 2022. Abstract 327. doi:10.1200/JCO.2022.40.6_suppl.327